Medical school: BAYLOR COLLEGE OF MEDICINE
Graduated: 1989
NPI: 1396874087
Practice Locations (2)
567 VAUXHALL ST EXT, SUITE 107
WATERFORD, CT 063854331
8604391980
567 VAUXHALL ST EXTENSION, SUITE 107
WATERFORD, CT 06385
Source: CMS National Downloadable File, September 2026.